The above studies measure OS from MDS diagnosis. The Canadian national MDS patient registry (MDS-CAN) prospectively collects detailed data on clinical frailty, comorbidity, and disability, as well as objective studies of physical function.
In an analysis of 219 patients with IPSS lower risk MDS with complete data for this analysis, 83 patients received ICT, and OS was measured from time of RBC TD.
Measures of frailty, comorbidity and disability at the time of TD were not different between non-ICT and ICT groups, however, median OS was significantly superior for ICT patients (p<0.0001).
In an MVA, receipt of ICT (HR for death for not receiving ICT 2.0 [1.1-3.8], p=0.03), disability score, & IPSS-R at the time of RBC TD were independent predictors of OS.
Removing patients who were upstaged by the IPSS-R, superior OS in ICT patients was still seen (p=0.01).
Matching patients for age, IPSS-R, number of RBC units/month and time from MDS diagnosis until RBC TD showed significantly superior OS for ICT patients (p=0.02; see Figure)1.
Preliminary results of the prospective, randomized, controlled trial of ICT in MDS examining EFS were recently reported2.